Cancer letters
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Machine learning (ML) is a branch of artificial intelligence centered on algorithms which do not need explicit prior programming to function but automatically learn from available data, creating decision models to complete tasks. ML-based tools have numerous promising applications in several fields of medicine. ⋯ For instance, they have been employed for oncological risk assessment, automated segmentation, lesion detection, characterization, grading and staging, prediction of prognosis and therapy response. In the near future, ML could become essential part of every step of oncological screening strategies and patients' management thus leading to precision medicine.
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Oesophago-gastric cancers (OGCs) are aggressive tumours. While better peri-operative strategies, increased number of cytotoxic agents and availability of targeted therapies have improved survival, there remains an unmet need for novel treatment approaches. Immune checkpoint inhibitors (ICIs) have marked a new era in cancer management with unprecedented results in several malignancies. ⋯ Furthermore, studies are evaluating ICIs in the early stage setting and exploring the potential of combination treatments. In this article we discuss the biological bases underlying the successful development of ICIs in OGC and review the available data on PD-1 and PD-L1 monoclonal antibodies in this disease. Also, we present ongoing clinical trials of these ICIs that could shape the future treatment landscape of OGC.
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Gastrointestinal (GI) cancer is a malignancy of the GI tract and accessory digestive organs. GI cancer patients develop resistance to chemotherapy, targeted therapy drugs and immune therapies. Although immune checkpoint inhibitors have shown promising clinical results in melanoma, etc., immune checkpoint blockade responds in only a subset of colorectal cancer (CRC) patients with microsatellite instability-high (MSI-H) tumours. ⋯ Immune suppressive cells, such as tumour-associated macrophages, regulatory T cells, and myeloid-derived suppressor cells, consist of a suppressive TIME to resist immune reactions. Combination approaches used to target the TIME, such as radiotherapy, chemotherapy, targeted therapy combined with checkpoint blockers or immune cell therapy, in addition to mono-immunotherapy, may provide better therapy responses. This review provides an analysis of recent developments regarding the role of the TIME in malignant progression, immunotherapy and the development of drug resistance in GI tract cancer, especially CRC, as well as approaches to overcome microenvironment-mediated resistance.
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Organoid technology has been remarkably improved over the last decade. Various organoids have been derived from different types of tissues and recapitulate their organ-specific gene expression signatures, particular tissue spatial structures and functions of their original tissue. ⋯ With the great expectations, PDOs will be widely used to facilitate the personalized medical decisions, which have the potential to profoundly improve patient outcomes. In this review, we will discuss the developmental details, current achievements, applications and challenges of organoid technology in precision cancer medicine.
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Microbiome is becoming crucial in that the balance between human health and disease can be mediated by the gut microbiome. The gut microbiome can modulate the host immune system both locally and systemically. ⋯ Here, we discuss the mutual relationship among gut microbiome, cancer, immunity, and cancer immunotherapy, with a focus on immunotherapy. Also, we briefly introduce the relevant challenges that affect the therapeutic efficacy and present the possible solutions.